Office of Residence Life residencelife@mail.sunyjcc.edu 716.338.1188 www.sunyjcc.edu/student-life/residence-life
J-Number
or SSN:
Jamestown Community College 1-Year Housing Application & License AgreementNEW RESIDENT
Student is under 18 years oldParental Signature Required
*The housing agreement will be binding for the entire academic year. This is not a lease and students are not considered
a tenant under New York Law.
Term: Fall 2020/Spring 2021 Academic Year* Spring 2021
Personal Info:
Class Year: Freshman Sophomore
Student’s Name: _______________________________ _________________________________
Perman
ent Address:
______________
________________________________________________________________________________
Street City State Zip
Date of Birth: __________________ Male Female Email: ___________________________________
Home Phone #: ________________________________ Cell Phone #: _________________________________
Have you been convicted of a felony? Yes No
Suitemate Survey:
All housing at Jamestown Community College’s Jamestown Campus is apartment-style living with four or five bedrooms,
two bathrooms, dining area, kitchen and living area.
Following the submission of your housing application and application fee, an email will be sent to the email address
provided above containing a Suitemate Survey. This survey is a tool used to match up residents based on various
criteria. Residents choosing to not complete the survey will be placed into general-population housing and will be matched
with suitemates at the discretion of the Director of Residence Life or designee.
Application Fee:
Application will not be considered until $200 deposit is submitted:
Fall semester only: Deposits may be split into two
payments of $100. All deposits for Spring applications must be made in full. Applications will only be complete after the full $200 deposit
has been made.
All deposits should be paid in full no later than August 1
st
for the Fall semester or January 1
st
for the Spring semester.
Payment Options:
Credit Card Payment (Complete a Housing Deposit after you e-sign this document):
https://campusstore.sunyjcc.edu/jamestown/merchlist?ID=32520
Send check for $200 to: JCC FSA: Attn Residence Life, P.O. Box 20., Jamestown, NY 14702-0020
Inte
rnational Students:
$200 fee may be sent through FlyWire Service. Please initiate payment as soon as possible as application is not
accepted until payment notification has been sent to JCC FSA Residence Life.
*Pleas
e note, applications are only active and a room is only reserved once a deposit has been received and a current
FAFSA has been received by the College.
*Request for a refund of deposit may only be made going into the fall semester. Requests must be submitted in writing
prior to July 1
st
. Any request made after July 1
st
will not be honored.
*2020-21 rates subject to change
Office Use Only: Deposit Received (1): / / 20
Application Received: / / 20 Deposit Received (2): / /20
Housing Assignment:
N S W Suite: _______ Bedroom: A B C D E
License Agreement and Terms:
1. The cost of housing for the 2020-21 academic year is $7,960.00*, paid $3,980.00 per semester for a single room. This cost
includes a basic 5 meal/week meal plan. See information below for enhanced housing/meal plan bundles available prior to
move-in.
2. The housing agreement is binding for the entire academic year; therefore, students are financially responsible for both Fall
and Spring semesters unless the Office of Residence Life is able to fill a vacancy from a waiting list. Exceptions may be made
by the Director of Residence Life or designee for extenuating circumstances, including, but not limited to, active military
enlistment or graduation. Housing occupancy is limited; students will be housed on a first come, first served basis. Students
who are placed on a wait-list, who have not been assigned a room, and have been notified of their wait-list status will have the
option of requesting their deposit back or moving it to the spring semester, in the event housing becomes available.
3. Full payment of students’ bills should be arranged prior to the start of each semester. Students may arrange payment through
the Financial Aid and/or Business Offices. Students intending to pay for housing, tuition and fees with financial aid are
encouraged to file for financial aid no later than April for the Fall semester or October for the Spring semester. Any student
owing a balance after financial aid is applied must demonstrate means to remit unpaid balance before being allowed
admittance into the residence halls. Students are encouraged to enroll in the Nelnet payment plan through the Business
Office. Students who fail to make payment arrangements by the due date(s) set by the College may have their housing
contract cancelled and/or have a hold placed on their student account.
4. Occupants agree that housing, tuition and fees will be paid by due dates and accept liability for any collection costs as a result
of failure to pay including, without limitation, collection agency fees, court costs and attorney fees. Occupants must
understand that if any portion of their account remains unpaid at the end of the semester, their account will be forwarded to a
collection agency within 30 90 days. Occupants must also understand that Jamestown Community College may contact
them by phone, e-mail, or text message regarding any outstanding account using any phone number, cell phone number or e-
mail that was provided to the college.
5. It is understood and agreed that you accept and agree to the terms and conditions of this license and that you are
responsible for adherence to all other policies specified in the FSA On-Campus Living Policies and the Constitution
of the Student Body. These documents are on our website: http://www.sunyjcc.edu/student-life/residence-
life/jamestown/policies and should be reviewed prior to signing this agreement.
6. Upon signing and submitting this Housing Application and License Agreement and $200 security deposit, I acknowledge that
I have reviewed the current On-Campus Living Policies and understand that I am responsible for its contents and the
policies upheld by the College, all as may be amended from time-to-time in the sole discretion of FSA and the
College. The deposit is non-refundable unless written request is made to the Office of Residence Life by July 1 prior to the
beginning of the fall semester, or one week before the start of classes in the spring semester. Written requests should be
submitted to residencelife@mail.sunyjcc.edu.
7. I understand that if I choose not to be a responsible resident, I will face disciplinary action. If found responsible for actions
causing damage to the residence hall or surrounding property or resulting in breach of safety or security of residents, including
myself, I will be liable to pay damages and face possible expulsion from JCC Hillside Suites Residence Halls and the JCC
Residence Life Program.
8. I understand that the Residence Life program reserves the right to consider various factors, including space availability and
resident history, conduct, and compatibility, when making housing assignments. The submission of this application and the
suitemate survey does not guarantee that a housing request(s) will be honored.
_ __________
___________________________________ ______________________
Student Signature Date
___________________________________________________ _______________________
Parent/Guardian Signature Date
*Students under 18 years of age must have both student and parent/guardian signature to be valid
MEAL PLAN UPGRADE OPTIONS: Commit before August 21 to save $250 on a meal plan upgrade! Please choose an upgrade option below if you
wish to upgrade from the standard 5-meals per week & 75 J-Dollars. All upgrades after the start of classes will revert to original, non-discounted prices.
10-Meals per Week & 125 J-Dollars + Housing Cost
Single Bedroom: $4,480/ semester
15-Meals per Week &175 J-Dollars + Housing Cost
Single Bedroom: $5,100/ semester
**Proof of immunizations are required by JCC Health Services and may be submitted to the Health Center. Submission of the immunizations are not required to
complete the housing application but residents may not move into the residence halls if immunizations are not on file. For more information, please visit:
https://www.sunyjcc.edu/student-life/student-services/college-health-services